BD is a global medical technology company that pride's itself on advancing the world of health by improving medical discovery, diagnostics and the delivery of care. With thousands of patented medical devices and unique procedures under their belt, it comes as no surprise that they need innovative training solutions to match. Our team at Accomplice was asked to create an augmented reality training system for BD's WavelinQ™ EndoAVF procedure.
THE CHALLENGE
Augmenting medical training
The WavelinQ™ EndoAVF System is a device and procedure combo that revolutionizes the way arterial-venous fistulas are created in patients who qualify for candidacy. In its 10 year history, physicians training has traditionally been performed on cadavers in a clinical setting. There are many issues that exist with the current training that our solution aimed to solve.
ACCURATE CANDIDATES
Cadaver limbs are not screened for candidacy prior to being purchased and shipped for training. This means you may or may not have true candidates for physicians to train on.
UN-RESTRICTED AVAILABILITY
Physicians training is currently held bi-weekly with a max of 12 attendees at each session. This directly limits the scale and reach of the value the procedure can bring.
PORTABILITY
Other training units exist, but are not portable since weighing over 50 pounds each. They are also very expensive, costing ~$90k per unit.
COST EFFICIENCY
Each attending physician needs to be flown out to the training facility and housed for the two-day training. The clinical facility also needs to be rented, cadaver limbs purchased, craft and hospitality planned, and so on.
OUR GOALS
Emerging tech meets medicine
We set off to create a system that would solve the four main points from above, with the main goal being to ultimately replace cadaver-based training. The system consists of an iPad that will drive the experience from a custom application, an iPod for 6DoF tracking, Polhemus micro-sensors for catheter tracking, a forearm prosthetic, and an arm mount that mimics a C-Arm’s movement. As the sole designer on the team, I spearheaded the following streams:
01. Research & Discovery
02. Information Architecture
03. UX Design
04. UI / Visual Design
RESEARCH & DISCOVERY
Scrubbing up and diving in
In order to properly design the system and account for all the possible states that needed to be considered, I had to understand the ins-and-outs of the procedure. This meant "scrubbing up" and attending physicians training. I was fortunate enough to be able to observe the procedure on cadavers, document the equipment used, and interview clinical specialists.
INFORMATION ARCHITECTURE
Mapping out the procedure
Following physicians training, I was able to map out the organization and user flow. The solution would consist of a patient library where physicians could choose from multiple cases, be able to determine candidacy based on vessel measurements, and if a candidate, jump into the AR experience of the simulated procedure.
ARTS SITE/USER FLOW MAP
This map outlines how a user will flow through the main segments of the app. It accounts for user actions, unique screens or modals, and the choices they need to make to get into the AR experience.
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PROCEDURE SCREEN USER FLOW
This accounts for all the logic the AR experience would need to account for within the context of the available actions.
UX DESIGN
Emerging tech meets medicine
Following physicians training, I was able to map out the organization and user flow. The solution would consist of a patient library where physicians could choose from multiple cases, be able to determine candidacy based on vessel measurements, and if a candidate, jump into the AR experience of the simulated procedure.
DETERMINING CANDIDACY
Physicians may know the anatomy, but learning how to correlate vessel measurements to determine a patient's candidacy is a major goal of the product's success.
BD has several different analogue materials that resemble this: a form for sonographers to record vessel measurements.
CASE OVERVIEW
It was important for the retention of the physicians to reinforce learning by supplying feedback based on their input.
FEEDBACK
REPLICATING FAMILIARITY
Ensuring key screens resemble the devices that the procedure is performed on helped bridge the gap between a user group that may not be tech-savy.
The procedure screen resembles the fluoroscopic system traditionally used to visualize the anatomy. The true change is turning traditional haptic actions into simple presses of a button.
FLUOROSCOPIC VIEW
The Bovi pen is what triggers the radiofrequency energy to fire through the catheter electrode, and create the fistula. A simple illustration helped disguise a "button push" as something more interactive.
BOVI PEN
USER TESTING FOR ADDED VALUE
We tested the wireframes on a few of the clinical specialists from BD to gain a greater insight on what and how to present the information needed to successfully train physicians.
I removed the anatomy illustration and enlarged the grid view so that users could focus on the most important data, versus be distracted trying to make sense of a graphic.
CASE OVERVIEW UPDATE
I added a Guided Candidacy feature that would help walk users through the 5 key determining factors for candidacy. This added more opportunity for the app to reduce the need for a proctor.
GUIDED CANDIDACY
To expand curriculum, we added another layer that would ask a physician to determine an appropriate procedure plan for candidates. This gave a greater value since it facilitated a deeper understanding of candidacy concepts.
PROCEDURE PLANS
With the added layer, we needed to guarantee physicians know the rules and laws around particular procedure plans. FDA labeling and legal compliance was super important to main BD stakeholders, so a conversational solution was needed.
PROCEDURE PLAN UPDATES
UI / VISUAL DESIGN
Working with the exsisting
BD had a pretty establish brand system, however this was mainly from a marketing or paper collateral standpoint. I was able to inform most of my design decisions from their marketing website, as well as introduce some new UX patterns. Throughout this project, every screen had to go through multiple levels of approval in order to get produced. BD Marketing had to ensure the brand was used correctly, BD Design focused on how this experience measured against their other digital products (mainly online apps), and BD Legal combed through every word to ensure FDA compliance.
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GUIDED PATIENT SELECTION
Walking physicians through the five primary considerations, while isolating relevant information helped solidify learning.
PROCEDURE PLANNING & MORE
Though physicians found it helpful to see all their choices laid out, a sequenced unveiling helped. Also, adding an overview to educate users on the benefits and challenges of their selection.
FLUOROSCOPIC CONTROLS
Leveraging the layout that physicians were familiar with, I organized controls in a manner that were easy to understand and flow through the procedure.
OUTCOMES
Survey says...
Following its debut of being incorporated into physicians training (as a rotation, not a substitute) I personally surveyed each attendee to gather their thoughts on ARTS and quantified it. With resoundingly positive feedback, ARTS has expanded uses and in addition will become a training tool for all clinical specialists. It has also been showcased at multiple conferences on endoscopic medicine and will continue to be iterated upon and improved.
PROJECT
STUDIO:
Accomplice
DATE:
May 2019 – Present
TEAM
PROJECT MANAGER:
Denise Burke
iOS DEV:
Tony Llongueras
UNITY DEV:
Clayton Stamper
DESIGN:
Britt Savant